Suspicious stress induced cardiomyopathy following hemorrhoidectomy under spinal anesthesia: A case report

A 48-year-old healthy woman was admitted in our hospital for elective hemorrhoidectomy. She developed sudden headache and chest pain, and showed sinus bradycardia, arrhythmia and hypotension forty minutes after spinal anesthesia with 0.5% hyperbaric bupivacaine. An EKG showed ST depression and an tr...

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Published inKorean journal of anesthesiology Vol. 56; no. 4; pp. 470 - 473
Main Authors Choi, Rak Min, Yoon, Jin Sun, Noh, Jae Hoon, Kang, Kyoung Oh, Kim, Min Suk, Cho, Sam Soon, Jun, Hee Jung
Format Journal Article
LanguageEnglish
Published Korea (South) 01.04.2009
Subjects
Complication
Ischemic myocardial stunning
Stress induced cardiomyopathy
Spinal anesthesia
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Summary:A 48-year-old healthy woman was admitted in our hospital for elective hemorrhoidectomy. She developed sudden headache and chest pain, and showed sinus bradycardia, arrhythmia and hypotension forty minutes after spinal anesthesia with 0.5% hyperbaric bupivacaine. An EKG showed ST depression and an transthoracic echocardiogram performed in PACU demonstrated mild LV dysfunction with hypokinesia of LV inferolateral wall. An coronary angiography on postoperative day 1 revealed normal coronary vessel and akinesia of LV inferior wall. Levels of CK-MB and Troponin I were mildly elevated. With medical therapy, the patient's symptoms improved and recovered without any complication.
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ISSN:2005-7563
DOI:10.4097/kjae.2009.56.4.470